Patients' families speak out over proposed Taunton State Hospital closure

As the debate about Gov. Deval Patrick’s plans to close Taunton State Hospital continues on Beacon Hill, several family members of patients committed there expressed fears about how the shuttering of the institution could affect their loved ones.

As the debate about Gov. Deval Patrick’s plans to close Taunton State Hospital continues on Beacon Hill, several family members of patients committed there expressed fears about how the shuttering of the institution could affect their loved ones.

While some expressed concerns about how the change of setting to a state hospital in Tewksbury or a newly constructed one in Worcester would affect the stability of the patients, others talked about fears related to proposals to put group homes in the community.

Group homes

Karen Curtis, of Harwich, has a 22-year-old son who is civilly committed at Taunton State. Curtis said that, throughout the past year, Department of Mental Health (DMH) officials have encouraged her family to consider moving her son to a group home closer to to her residence on Cape Cod. But she believes that this would be problem and that the setting could lead to safety risks or arrests because, by policy, the group homes are not locked facilities.

“He would not be safe there,” Curtis said, explaining that her son’s mental illness causes inappropriate behavior and is difficult to manage. “The regular group homes are places where people can come and go. They are expected to be completely independent, which is far different from the hospital, and that is a real problem for many patients whose families are being asked to consider the group homes. A lot of these people can’t be discharged too soon and can’t be managed in the community.”

Curtis said the shift from institutionalization to community-based care sounds good but that it’s not safe for all who are asked to consider it.

“If something goes wrong, the patients are the ones who get the blame because they are the ones who get arrested,” she said.

Curtis said that because her family rejected the proposed placement in a community setting, the plan is now for her son to be moved into one of the cottages on the Taunton State Hospital grounds, which she said is a much better alternative. But she feared that other patients may be rushed out of an institutional setting too soon into a group home.

Curtis said if the hospital ends up closing, it would likely mean her son would be transferred to the new Worcester State Hospital, which she said is a problem for her because it would take her 2½ hours to get there for visits.

“That’s why we are fighting so hard against the closing of Taunton State,” she said.

Concerns for patients’ safety

Michael Donovan of Norwood said in recent months DMH officials have asked his family to consider moving his mentally ill brother to a group home in Walpole, on a road where traffic moves steadily at 45 mph. Donovan said his 56-year-old brother, who has been in a state hospital since 1975, would likely end up harmed if he were to wander out of the home.

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“He doesn’t observe his surroundings very well,” Donovan said. “He’ll cross the street without looking left or right, and he hears voices from things that aren’t there and inanimate objects and things that are there. His sensory abilities are very off. He would walk around the street where there are cars and would walk into the road.”

Donovan also expressed concerns about understaffing at community homes, which are funded by the state and managed by private vendors. He said in some cases — like during the overnight period — there is only one person working at the home at a time.

Donovan’s brother is currently in a geriatric unit that doesn’t exist at the new facility in Worcester.

Margaret Derry, of Franklin, has a 64-year-old sister who is in the geriatric unit at Taunton State and has been institutionalized since age 19. While she said DMH officials have told her family that her sister would be moved to a group home in Walpole, she echoed Donovan’s concerns about unlocked doors and a busy Route 1.

“They might have a buzzer going off if a door opens, but she would probably get 15 steps out the door by the time someone could react,” Derry said. “There is no fence or anything.”

Derry also said that at Taunton State, medical services are readily available, whereas at the group homes, services are brought to the facility from outside. “Community placements are a lofty goal, but it’s not appropriate for all people, like my sister who needs help every day,” she said.

Officials’ stances

State Sen. Marc Pacheco, D-Taunton, said while he supports the DMH “community first” shift to group homes rather than institutionalization, the real problem is that, of the 169 beds at Taunton State, 149 patients are committed civilly or criminally. “Most of the patients at Taunton State will be in an institutional setting (because) it’s required (unless) they go to court and a judge changes the designation that’s been assigned to the patient,” he said.

While he said that taking beds from southeastern Massachusetts and shifting them to central Massachusetts is the primary issue he is fighting against, Pacheco also expressed some concerns about community placements, primarily understaffing at group homes. He mentioned the murder of residential counselor Stephanie Moulton, 25, of Peabody at a state-funded group home for the mentally ill in Revere in January last year, allegedly at the hands of a schizophrenic patient named Deshawn James Chappell.

DMH Commissioner Marcia Fowler responded to an array of concerns about the shift of patients to Worcester and Tewksbury, along with the community care push, during a recent telephone interview. She described the shift from institutionalization to group homes that has been going on for decades as a more humane strategy.

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“What we don’t want is people who don’t need hospital care to be sitting in locked psychiatric units when they should be, by the nature of the right thing to do and by the (Americans with Disabilities Act), receiving their services in the community,” Fowler said. “They really deserve to be in a much more humane and compassionate environment.”

Fowler said that DMH discharges from state hospitals to community care units is based on clinical reviews that ensure it is appropriate for the patient, and that no one is discharged to another part of the state unless it is specifically requested. “If it was someone who was considered a danger to themselves or others, they would not be discharged. That is a criteria for our community facilities,” she said.

Fowler said the staff at the community homes are highly trained and that there are daily check-ins and a broad continuum of services offered.

Responding to concerns about understaffing, Fowler said, “We shy away from mandating certain staffing requirements” so that the provider doesn’t get “locked into conditions.” She said staffing is based on needs of people living at the homes.

Regarding the potential for cases similar to the murder of a worker at the community placement in Revere, Fowler said this situation was an anomaly.

“I think if you look at the incidents of violent events across the population at large you’ll find the incidents that occur in any human delivery service system is far lower than what occurs in the general population,” she said. “Particularly, people with mental illness are four times more likely to be victims rather than the perpetrators. It’s an anomaly what occurred there (in Revere) and it is certainly not the rule.”

Effects on patients

Brenda Venice, president of the National Association on Mental Illness’ southeast division, warned that taking patients out of a hospital setting and putting them into the community too early to save money could result in the patients not getting well, often ending in them leading lives of homelessness or crime.

Venice also said that transferring patients from Taunton to Worcester would be disruptive in terms of their treatments.

“You are taking away their safety net, something they are familiar with,” Venice said. “They are familiar with the staff people. They know their names and get to know them. It’s not good to do that. It’s not good to take people to different areas.”

On the other hand, Fowler said the new facility in Worcester would be more soothing for the patients, and she added that most patients in Taunton State currently will have been discharged by the time the Taunton facility closes.

“I think that patients who are admitted into the new Worcester Recovery Center and Hospital will get a profoundly positive effect,” Fowler said. “It’s an incredible environment filled with light. The rehabilitative opportunities are amazing. It’s a state-of-the-art facility designed for the enhancement of mental health services.”